9601-093 (CP)LICENSED CONTRACTOR DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and Professionals Code, and my
License is In full force and effect.
License # . Lic �C�a s�� Exp; Date $�S
Date ✓/ / Signature ofContractor v'La 1�s.. •� ..-
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the
following reason:
() I, as owner. of the property, or my employees with wages as their sole
compensation, will do the work, and the structure is not Intended or offered for
sale (Sec: 7044, Business & Professionals Code).
( ) I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec. 7044, Business & Professionals Code).
( ) I am exempt under Section B&P.C. for this reason
Date Signature of Owner
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
( ) I have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by Section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
( v)�I have and will maintain workers' compensation insurance, as required by
Section 3700 of the Labor Code, for the performance of the work for which this
permit is issued. My workers' compensation insurance carrier & policy no. we:
Carrier -Policy No. ..rose
(This section"nee riofbe completed if the permit valuation is for $100.00 or less).
( ) I certify that in the performance of the work for which this permit is issued,
I shall not employ any person in any manner so as to become subject to the
workers' compensation laws of California, .and agree that if I should become
subject to the workers' compensation provisions of Section 3700 of the Labor
Code, I shell forthwith comply with those provisions. ✓� ! �.-
Warning: Failure to secure Workers' Compensation coverage is unlawful and shall
subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages, as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his application.
1. Each person upon whose behalf this application is made & each person at
who66 rdyubsl grid fur whuse benunt wuik Is performed under or pursuant to
any permit issued as a result of this application agreesto, & shall, indemnify
& hold harmless the City of Indian Wells, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and vold
work is not commenced within 180 days from date of issuance of suc
permit, or cessation of work for 180 days will subject permit to cancellatio D
I certify that I have read this application and state that the above informati
correct. I agree to comply with all City, and State laws relating to the bui Ing
construction, and hereby authorize representatives of this City to enter up the
above-mentioned property for inspection purposes. 1
Signature (Owner/Agent) /�°��.�//"v L..� °�Date
ALC "
BUILDING PERMIT
PERM"'
y601-.69
DATE .1/1706
VALUATION �2�,F�If1 (��
LOT
TRACT '
JOB SITE ADDRESS
APN
_541-915 RAM ROWCOURT
WNER
CONTRACTOR
STFVE, D013SON CJNC1'_RUc'` 1ON
WILLIAMS DE`.E[,OPA1ETTI":
68805.A MU.RD. #!~9
42600 C',.t ROL[NE CT. 0101
CATHEDRAL CITY CA 92234
PAL.IV DESERT CA 92260
tfi t 4i324t 2 i2 ("RE -4 1044
DESIGNER/ENGINEER
(M 4)}i4,j �880
USE OF PERMIT O()L kkNEI10,11 SPA
COMMON AREA POOL
FEE DESCRIPTION
FEES
COMRACT AMOUNT 21,000.00 LS
0STMAKf LM C0.510F CONSTRUCTHON
21,0.00.4H)
PERMIT V1r✓ C 5916' A A.RY
AAN CMCK FL:F 101-0004V-318 $140AQ
iCONSTRUC IDN FTE 1.01-000.4:1$-004 Sr?I ,OrJ
MECHAN1'CAL A46L —.POOL. 101-000-421�000
ELEC: ERTCAL, FEE -- FOOL 101-000420-0) $45,00
PLUMB EEE --PO OL. 101-000.419-000 $27,00
40� SUB -TOTAL CONSTRUCHON AND PLAN CHECK
$4.52-,Atl
LESS PRE-PAWEVS
$0,00
TOTAL b'ERNIrf lA EE.S :DVE NOSY
W2.40
JAN 1 8 19,96 .
R CEIPTAT
BV :
DATE FINALED
INSPECTOR '
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wall Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
BLOCKWALL APPROVALS
Steel
POOLS - SPAS
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
Final
Gas Piping
PLUMBING APPROVALS
Gas Test
Electric Final
G
Waste Lines
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K. for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
Final
Final
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility -Notice (Perm)
COMMENTS:
£o 'd
q4z,
K
VICULL619 'ON XVJ IMUdouAH SWV1111M 03 L';:Vl 3AI 96-91-NVf
JLIL-19-95 WED 11:22 FAX NO. 8638303. P. 01
OWNERS NN1Ii/ADpRL•,si
COUNTY 'OF RIVERSIDE -' DEPAJ3-jTIEN-r of HEALTH •
ENV I'RONMENTAL HEALTH SERV I C' Es DI V I S 1 ON
COMMERCIAL POOL SPECIFICATION SHEET DODSON POOLS
73-011 COUNTRY CLUB DR: STE. F4
Lam/'PALM. DESERT, CA'92260-
(DBA)--T �` S'/ S�i✓� I1110NE NO.
CONTRACTOR'S NAIvfE/ADDRESS PHONE NCS. &%9— 3Y1 •- S/p3Z
POOL LOCATION/AUORESS�,a,-r
PLOT PLAN.- SHOW ALL. EXISTING AND PROPOSED FACILITIES (SEPARA'T'E SHEET)
SCALP.. (14"=. 1') - PLAN &.- PROFILE REQUIRED. ENGINEERED PLAN ON FILE III BUILDING DEPT. C---
NECIIANICAL•EQUIPMENT -- MUST BE -FROM L.A. COUNTY HEALTH DEPT. APPROVED LIST.
NOTE:.. INCLUDE MECHANICAL EQUIPMENT AND PLUMBING LAY -OUT ON PL
APPROVED RESTROOMS REQUIRED DWELLING UNITS GREATER THA 300 FROM POOL OR NON-
RESIDE14TS ALLOWED Yes y-" No.(If.yes, show detailed pla
APPROVED SHOWERS REQUI1tED Yes No (If yes, show detailed Flan)
1. TYPE OF POOL STANDARD Zl_— OTHER
2., 'CAPACITY _VtALL0NS
3.:' SURFACE ARL 2 / S . FT. Max. occupancy p }� (must be'posted).
4. TLJR14 OVER. T'1M- . ;5HRS. (6 HRS.. STANDARD)
5. NO. OF SKIMi,1ERS (one per SOO sq. ft. regd) .
Make 2.- i rl. lodelr�I,/— 3
o Equalizers Req iz d /
o Size of Suction Line(s) 2 inches
e Number of Return Inlets Size(s) 1.s in.ches
Diameter of Plain Drain wit Safety Cover __inches
® Type of Pipe:
I PVC to .11g" Sch. 40 Over l'-" Sch. 80
—E -Inlets located 18" below water level and 10' apart and fitted with
directional fittings.. (If pool] 40' wide, floor= inlets required)
FIL'L!R TYPE AND SIZE
1. D.E. @ 2 gal/min/sq. ft.
2. SAND @ High rate -15 gal/min/sq. ft. MAKE C.�
@ Rapid rate - 3 gal/min/sq. ft. MODEL
3. CARTRIDGE @ 375 gal/mi /sq. -ft.*
PUMP: MAKE a'z� �IODEE�%��; 1'�. 1P_` ;a GPM @ 60' TDH2�
SEPARATION TANK �t MAKE �bf0U1; _ -Size of Dry Wel 1 �� X � (D
BACKWASH .via proper air gap :(visible to operator or site glass also requireil�-
POOL CONSTRUCTION - Gunite J_ *Fiberglass Other COLOR -WHITE
CHLORINATOR: t1AK2y,4W ,-4 -MODEL (Special requirements apply if gas)
FLOW h1ET•ER�(S) : D-AKL MODEL Ilifluent and effluent pressure gauges
TYPE -OF HAND HOLD PROVIDED AROUNq•POOL PERIMETER (must extend 1" to 2" into pool and be .
'no -more than 21_" Bullnose.
ALL CORNERS COVED
SAFETY EQUIPMENT -
1. ALL SAFE'T'Y SIGNS INCLUDING "NO*DIVING ALLOWED FOR POOLS LESS TW.N 6 FT. DEEP."
2. BODY HOOK 1/LIFE RING 4 ROPE (WIDTH OF POOL) r APPROVED -T•EST KITS) �
PROPER LADT -27 OR APPROVED RECESSED .S'T'EPS WITH GRABRAB RAILS PROPER STEPS
POOL VACUUM t_—UNDERWATER LIGHT L__ PROPER HAND RAILSLADDER (S) _-
3. DEPTH MARKERS -STANDARD (SIDES u ENDS -INCLUDE DECK IF POOL GREA'T'ER THAN 20 FT. WIDE).
4. POOLS GREATER THAN 5 FT. DELP - 411 WIDE LINE ACROSS BOTTOM AT 4'_ FT DEPTH ; .'I:NCLUiIFS
POPE -ANCHOR CUPS.
ADDITIONAL REQUIRENIENTS:
I. Unobstructed non -slip walkways 4 ft.. wide around the pool perimeter and must be sloped to
drain away from pool .and into proper drainage system. (If deck drains are present, one
drain -every 400 ft. and no more than 25 ft. apart and must flow to an approved drainage
system'.) •
2. All pools must be at least 6,ft.-apart. .
ose b.ib� with proper vacuum- breaker: s located so that a 75' hose can, reach all portions of- deck
4. Aft: high fence around pool with self-closing and latching gate(s). Latch must be at
least 315 ft. above ground.' - Openings in fence must not exceed 4" in width.
S. Equipment placed on goncrete slab sloped 2% toward approved drainage.
6. All valves and controls must be identified and an 6perations manual provided to operator.
7. FilI.line with an approved backflow preventer. (Water supply. must be from zn approved
system.)
SPECIAL REQUIREME:N'T•S:
SPECIAL APPROVAL REQUIRED.
For•f-inal_approval, call
SPECIAL NOTE: 'THIS SPECIFICATION SHFET MUST BE COMPLETED IN ITS ENTIRE -Y AND ALL PERTINENT
JUL-19795 WEU 1123
)IMERS NM1E/ADDREiSS (DBA)
ONTRACTOR 1. S' NAME-1ADDRESS
OOL LOCATION/ADDRL'SS
FAX N0, 8638303 P.02
COUNTY Or"R1VErLSIDE - NFr ^—nT-mrr4T Or'.,tIFAL71-1
ENV I R0111MENTAt sCRV I Ctrs D I v t S I ON .
COMMERCIAL SPA: SPECIFICATION SI1LL•'.F
ev
DODSON POOLS
73-011 COUNTRY CLUB DR. STE. F 4
PALr�t DESERT CA 92260
1'l1014C. 14U. . .
. -37,eV �2
PLOT PLAN' - S1101Y .ALL EXISTING AND PROPOSED FACI LITIES (5L•1'ARATE SHFUT) .
SCALE (1" - 1') - PLAN & PROFILE REQUIRED. nGIncm.'1) PLAN ON FILr IN BUILDING IX. -PT.
MECHANICAL EQUIPMENT - MUST BG FROM L.A. COUNTY I-JEALI11 ULPT. APPROVED LIST'.
NOTE: INCLUDE MECHANICAL EQUIPMENT ON PLAN F PROFILE SHEET,
APPROVED REST,"0011S REQUIRED IF DWELLING UNITS GREATER 'ITIAN 300' FROM 51'A Olt NON-
RESIDENTS ALLONED.Yes No (If yes, show detailed flan)
APPROVED SHOWERS REQUIRED VY -es No (if yes, show detailed plan)
1. GOnite—
Fiberglass Other
2 CAPACITY /-6;GALLONS
3. SURFACE ARE -A" -'K/ SQ. FT. (250 sq. ft. max.). Max occupancy (must be post
4..t TURN OVER TIME_ y (30 MINUTES MAXIMUI'd)
5.' •SKIMER(S) .
. • PIAKE��'�G%�l �L��1`10UEL
e' •Equalizers Required
® Size of Suction Line (s) inches
e Number of Return Inlets size(s) /..-S inches
O Minimum of one return line, with directional 7 fitting 2
o Diameter of Main Drain with Safety Cover
a TYPE of Pipe:
L��PVC to 11-i" Sch. 40 L_ Over 1!i" Sch. 80
FILTER TYPE ANU SIZE
1. ".E. @ 2 gal/min/sq. ft.
2. SAND @ Nigh rate -15 gal/min/sq. ft. MAKE:
@ Rapid rate - 3 gal/min/sq. ft. MODEL
3. CARTRIDGE @ .375 gal/mirt/sq. f`
PUMP: MAK);. � l DfODE;L i/1 � � IEP -�)Z� GPM @ G0' TGII
SCPAIZAH0N TANK * 14AKE �l`1UuEL Dry well size Z��7 X
BACKWAS11 via proper air gap. (visible to operator or sire glass alsu rc quired) . foos,�n�J_`
SPA CONSTRUCTION -' G ni.te 'L *Fiberglass Other COLOR - IVIIa.te or Light Past
CHLORINATOR: MAKE ,�/ / < MODEL (Special requirements if gas) .
FLOId METERS) : bla e Model Influent Effluent pressure g..►u9cs^ <
TYPE OF IIAND'HOLD PROVIDLD AROUND SPA H, TER Bullnose Other
ALL CORNERS COVED
SAFETY EQUIPMENT
.1, ALL SAFETY SIGNS. -
BODY HOOK LIFE; RING & ROPF APPROVED TEST KIT(S) L_ PROPER ST1sFS��_-.
SPA VACUUM UNUEii1VA1'ER LIGHT �__ PROPER HAND RAILS
3. DEPTH t MARKERS - TI JINIMUM.
�'.4. CONTRASTING COLOR SLIP-J2ESISTAI,11' TILE: ON EUGh OF SLATS AND STEPS.
5. JET -SYSTEM ON SPAS - MINIMUM OF TWO (2) INTAKES SEPARATED. BY A' LEAST 2j'T, AND FI'
WITH SAFETY COVERS (J1 '1' & RECIRCULATION SYSTEMS CM4P40'1 BE. IN1'ERC0PJNEC'l'I:U) . NOTE:
�DITIOrJnL REQUIREMENTS: JAY NUT BE USED AS ,Art INTAKE FOR THE.JET SYS'T'EM.
Unobstructed non -slip walkways '4 .ft. wide around at least so,of the pool Eicrimcter cul
be sloped to. drain array from spa and into proper drainage system. If deck eTruAns are
one drain edcry 400 ft. and no more•than 25 ft. apart and mu
must flow to n approved. dra
System) ,
All'spa$ and pools must be at least 6 ft. apart.
Pr vide Bose bib within 75 ft. with approved vacuum breaker. Latch must be a
�'
Aft. liigll fence arounel.spa with Sclf-closing and latching gate(.$).
least 3!j ft. above g:roulld. Opeld1195 • in fol,QtIIILISt llot cxcoccl 4" i.=l wiclt lI.
Equipmunt placed on concrete slab sloped 2% toward approvuu .Jz'aitta;u'.
All valves and controls must be identified and an operations ma11ual provided to operat.
Fill lino with proper backflow preventer. .(Wager supply must be from ail nI)i�roved syscE
Emergency Shut-off Switch required. (one switch must -turn off all. PumPs)
CIAL REQUIREM1:11TS:
IPt TAL A11111tOvA►, lMQQ11tl3u. 16;E lilt) approvEllt cii11.
v*�
Ci
NI
9'
10'
10'
-
"Approval of these p'a„n by I
Departmeril 01 L.L
En irleer or A� it
9
or Arch itectur£ i
Ch ae"
„.
` . , ' �".I T� ', IT 0I" Eta°, I
c�
i'
j f
_
POOL LIGHT 500 WATT
SPA LIGHT 100 WATT
CLOCK 2.20 V.
ELECTRIC BY
ELECTRICAL BONDING BY:
TILE AND COPING
DECKING BY OVERS
i'
v*�
Ci
NI
9'
10'
10'
-
"Approval of these p'a„n by I
Departmeril 01 L.L
En irleer or A� it
9
or Arch itectur£ i
Ch ae"
„.
` . , ' �".I T� ', IT 0I" Eta°, I
c�
CONTRACTOR (INITIALS)
PLAN APPROVED BY
E.G. WILLIAMS COMPANY,INC.
OR AGENT.
101
NOIE:
HANDICAP FT
WITH BOND D SLEVE
C�t
NOTE 40 SQ. FT. EXTRA
DECKING REQUIRED
AT SPA AREA FOR MINIMUM
CLEARANCE
4
6'
4-
R.
SL�
III -r- RAO
1 112" RETURN LINES 4' 4' ID
.14 1 1/2 18" MIN. BELOW WATER
_ — — — — — — — 2 — — — — ---j
WITH AJUST. EYES
0 1 /2" 1
1
I
LT J
SPA EMERGENCY
SHUT OFF SWITCH
ALL SAFETY
SIGNS
SUB
PANEL
BY
OTHERS
•�— q —Wj ��: i I I vi
C I
S 7D
2„ EQUALIZER LINE WITH t e` C
ANTI V. COVER Ci- II
L3'
11
d .. - /in n \ �- W- r ?. r "P•A N n !c 3' '
Ii 1E N i II
GENERAL SPECIFICATIONS
Ss: ark, . I m : a,, / I SIZE
S�liBJ1ECTTO I"': ST r Li� a lits"ti i 6r`, DEPTH 9 X 34 �AR_EA_��1—.
,
SHAPE --3 T PERIMETER 114
TILE SIZE
D ALL APPLICABLE CODES / / TILE COLOR
♦ COPING cantilever
DATE gy
IT // COPING COLOR
// /♦ POOL CAPACITY 18,380.6 GALS °
\ // // // / ♦/ PUMP CAPACITY_ �")•k GPM
_NO"(j [-- MOTOR HP STA RITE �1.) HP
♦ /MUSTEE '13 ,AINED FROM THSFILTER REQS 6-0 sQ �
/ //// / ♦ ♦/'�` PERMIT � _ O
f�F PnJVIROPI��ENTAL HEALTI? FILTER RATE 120 GPM
r - / / / ♦x 91 OF RI°v Cr~ f ,i � � F � �.
y r < M [� r� TURNOVER 5.5 HRS
VACUUM UNE & SKIMMER 2 "
—1
-HIS HIS AAPTV PP a r I . `As h d O .� � RETURN LINE 2 "
/ %';� e 'FN�"LeII��.. _MAIN DRAIN 2 "
i, / I/ RT E:i � ) v' -R 0 ME=NTAL. HEALTH SKIMMER_MODEL �1_3
6 AUTO / ♦ ECS s l;w ( ) `1` ,.,;< 3 s�rr: D , r OP AIBP 1OV ANTI -SYPHON VALVE YES
FILL I ,._ - °� HEATER LAARS SIZZEAOO BTU
1
I 21.8335'
1
2" / 1$
/ 2„
/ /
"Approval of these p'a„n by I
Departmeril 01 L.L
En irleer or A� it
9
or Arch itectur£ i
Ch ae"
„.
` . , ' �".I T� ', IT 0I" Eta°, I
ie County of Riverside
A� not relieve the
�, ,es
6Y -•:.,;,linty for the Engineering
�;
:C� �a MEIdTAI- P4ZX .
GASLINE BY OTHERS
_
POOL LIGHT 500 WATT
SPA LIGHT 100 WATT
CLOCK 2.20 V.
ELECTRIC BY
ELECTRICAL BONDING BY:
TILE AND COPING
DECKING BY OVERS
CONTRACTOR cannot assume
responsibility for damage to
t
3.2 5'
curbs, sidewalks, driveways,
cement slabs, sewers,
lawns,trees, fences, retaining
walls, sprinklers, telephone lines
1 1/2" 3 -�; esl
or shrubs. When access is made
/
Vic �..m f ita 23 a;" :r ', Alpifl-ce, ltr through a neighbor's property it is
understood that you, the owner,
I
have that neighbor's permission
Call for In` ,Ot" I �A, inspections should
bc in eer and assume full responsibility.
LARRS HEATER 400,000 BTU B:`Z 3 Name: E.G. WILLIAMS DEV. COMPANY
PUREX 60 SQ BMBW THE SEASON
- - -__ - _----------- ---- ----- Address: 50-915 RAINBOW COURT
- --STA-RITE P4EAPFL 1-1/2 HP. 50' HEAD 72 GPM 5 HR. 21,600 GALLENS
_--------_---___------------ -- TRACT 28019, LOT 1
•^c e t ?
,� F._ D,� 3�D"il$ City, LAQUINTA CA.
_� qyg p
Li:t Set;r C,- P'aaLi:-d'9��'JI9�t i� I-I'i✓� �i 0 , �
LATCwNO OKi;E.
— CARR$ HEATER 250.000 BTU
— PUREX 36 SO. BMBW
STA -RITE P4EA6EL 3/4 HP _ '
--- CIRC PUMP 60' HEAD 45 GPM 30 MIN. 1350 GAL. _ SHOW ROOM
1 STA RITE 3_HP JET PUMP PLUMBING 73011 COUNTRY.
- - PALM DESERT CA. 92260
-------- SUC.---- — PHONE (619) 346-4032
SCALE -114" =A_'.
DIS. -- --------- LIC # A-574127
r
0
8 JETS
i
ANTI V. COVER
d1um
16"
I
�CALE: 1/2" = V
the step term
1�-
c
Wt �- 0 c3
GENERAL SPECIFICATIONS
SIZE 9 X AREA 81
_1n
DEPTH 3'6"
SHAPE PERIMETER 36
TILE SIZE
TILE COLOR
COPING cantilever
COPING COLOR
POOL CAPACITY-_` GALS
PUMP CAPACITY�GPM
MOTOR HP sta-rite—U,4 HP
FILTER purex 36 sm w SQ FT •d
FILTER RATE nGPM
TURNOVER 20 min- HRS
VACUUM LINE & SKIMMER 1-1/2,
RETURN LINE 2-1-1/2 IV
MAIN DRAIN 1-1/2 "
SKIMMER MODEL u-3 swimquip
CHECK VALVE
HEATER LAARS SIZE 250 BTU
GASLINE BY others
POOL LIGHT
SPA LIGHT 100 watt
CLOCK 220 v.
ELECTRIC BY
ELECTRICAL BONDING BY: s.d.c.
TILE AND COPING
DECKING BY others
CONTRACTOR cannot assume
responsibility for damage to
curbs, sidewalks, driveways,
cement slabs, sewers,
lawns,trees, fences, retaining
walls, sprinklers, telephone lines
or shrubs. When access is made
through a neighbor's property it is
understood that you, the owner,
have that neighbor's permission
and assume full responsibility.
Dame.: E.G. WILLIAMS DEV. COMPANY
THE SEASONS
Adcl-r-esz: 50-915 RAINBOW COURT
TRACT 28019, LOT 1
LA QUINTA CA.
SHOW ROOM
73011 COUNTRY DR.
PALM DESERT CA. 92260
PHONE (619) 346-4032